Effective Intervention Programs Research Articles

Exploring the spatial pattern of animal bites in Iran (2021–2022)

ObjectiveKnowledge of the spatial pattern of animal bites can be helpful for targeted resource allocation and to develop and deliver effective intervention programs. The aim of this study was to explore the spatial pattern of the animal bites in Iran during 2021–2022. MethodsAnimal bite cases from all provinces and counties in Iran were obtained from a nationally based registry. Global Moran's I was applied to check spatial autocorrelation. The spatially adjusted standardized incidence ratios (SIRs) were estimated using the Besag, York, and Mollie (BYM) model. Spatial clusters were identified by local indicators of spatial association (LISA) and purely spatial scan statistic. ResultsA total of 260,470 animal bites were registered during the study period. There was a positive spatial autocorrelation (global Moran's I=0.27, p-value=0.001). The majority of SIRs greater than 1.00 was found in counties in the northern belt of Iran (e.g., observed greater than expected animal bites). LISA found that approximately 7% of counties in the north and northeast, 18% in the west and south, and 3% in the central part of Iran were significant hot spots, cold spots, and spatial outliers (p-value≤0.05). Spatial scan statistic detected primary hot spot cluster in the counties in the Mazandaran and Alborz provinces (Relative Risk=2.56, p-value<0.001), while primary cold spot cluster involved counties in Kurdistan and Kermanshah province (0.37, <0.001). ConclusionAnimal bites were unevenly distributed in Iran. Further prevention and control programs as well as appropriately resource allocation are needed in order to reduce the observed animal bites spatial disparity.

A Qualitative Analysis of Older Adults’ Cognitive Appraisal in Coping during the COVID-19 Pandemic: The Role of Social Capital

The ability to adaptively cope with the challenges of stressful events such as the COVID-19 pandemic is crucial for healthy aging. One effective coping strategy is social coping in which social networks are tapped for support. However, our review of the current literature on older adults’ coping abilities reveals two shortcomings: (1) a lack of consideration of a specific context and (2) an inadequate amount of attention paid to the different types of social networks in the cognitive appraisal process. As coping is a process in which older adults undergo the cognitive appraisal process to identify appropriate coping strategies, the shortcomings result in an incomplete understanding of older adults’ coping efforts and impair the development of effective community and intervention programs to improve older adults’ well-being. To fill this gap, drawing on the Transactional Model of Stress and Coping and the Social Capital Theory, we conducted 22 interviews with older adults who experienced lockdown measures during COVID-19. Our in-depth qualitative analysis shows the different roles played by bonding and bridging social capital in the cognitive appraisal process and illustrates the influence of a specific context on cognitive appraisals and subsequent coping efforts. Our findings provide significant contributions to theories regarding coping and social capital, as well as practices and policies for improving the well-being of older adults.

The relationship of exercise and cancer-related fatigue in patients with advanced liver cancer: a cross-sectional study

There is increasing interest in understanding exercise as a potential treatment for cancer-related fatigue (CRF); however, rarely research has been conducted on more aggressive cancers with short survival, such as liver cancer. The purpose of this study was to provide educational ideas for insufficient exercise and provide clues for the design of effective and safe exercise intervention programs with high compliance in patients of advanced liver cancer in the future. Participants were recruited from a tertiary cancer hospital using convenience sampling. All participants were asked to complete self-report questionnaires that assessed their medical and demographic variables, exercise habits and CRF during their hospitalization in the interventional department. Spearman’s correlation analysis and Nonparametric test was used to explore correlations between exercise subgroups and CRF. The Baron and Kenny’s Approach was used to investigate the mediating effect of exercise index between P-EX and CRF. 207 out of 255 participants were enrolled in this study, with an average age of 55.4 years. The CRF score was 33 (28, 36), and 93.2% had insufficient exercise. Exercise frequency (≥ 3 Times/week) (Z = 4.34, p = 0.037) and maintaining exercise trend (Z = 15.85, p = 0.001) had a positive effect on CRF. P-EX had a great impact on exercise index and affecting CRF directly. Participants in the study showed serious fatigue and insufficient exercise. Exercise education can be initiated earlier, particularly those without regular exercise experience. Sustained light exercise, compliant with exercise habits and interests, three times a week may be a practical way to reduce the risk of CRF in advanced liver cancer.

From procrastination to frustration—How delaying tasks can affect study satisfaction and dropout intentions over the course of university studies

Procrastination leads to obstructive consequences for students in higher education. Cross-sectional studies show that procrastination is positively associated with study dissatisfaction and students' intentions to drop out of their university degree program. However, the reciprocal effects between these variables throughout an entire university degree program are still equivocal. Drawing on a sample of N = 463 students enrolled in university teacher education and applying cross-lagged panel modelling, this is the first longitudinal study that provides evidence that procrastination leads to dissatisfaction while dissatisfaction leads to dropout intentions over the course of three years of studying, rather than the other way around. Our findings support the relevance for universities to implement effective intervention programs to help students reduce procrastination, improve their well-being, and decrease their intentions to drop out of their university degree program. Educational relevance statementThe most detrimental effects on higher education students' achievement-related behavior and well-being are due to their maladaptive learning strategies indicated by procrastination. The main goal of the present research was gaining deeper insights into the reciprocal relations between students' procrastination, study satisfaction, and dropout intentions in higher education. It should be noted that the reciprocal effects between these variables throughout an entire university degree program are still equivocal. In this study, we examined individual differences in the longitudinal and possibly reciprocal associations between procrastination, study satisfaction, and dropout intentions over the course of three years of university education. This is the first longitudinal investigation that provides evidence for the hypotheses suggesting that procrastination leads to dissatisfaction while dissatisfaction leads to dropout intentions over time, rather than the other way around. Our findings have practical implications for implementing prevention and intervention programs at universities that can assist students in decreasing procrastination, improving their well-being, and reducing their intentions to drop out of their university degree program.

Glycemic control and its associated factors among diabetic heart failure outpatients at two major hospitals in Jordan.

Patients with heart failure (HF) are generally at higher risk of developing type 2 diabetes and having uncontrolled blood glucose. Furthermore, the prevalence of uncontrolled blood glucose in patients with HF is largely unknown. Identifying the factors associated with poor blood glucose control is a preliminary step in the development of effective intervention programs. The current cross-sectional study was conducted at two major hospitals to explore the factors associated with blood glucose control among patients with heart failure and type 2 diabetes. In addition to sociodemographic, medical records were used to collect medical information and a validated questionnaire was used to evaluate medication adherence. Regression analysis showed that poor medication adherence (OR = 0.432; 95%CI 0.204-0.912; P<0.05) and increased white blood cells count (OR = 1.12; 95%CI 1.033-1.213; P<0.01) were associated with poor glycemic control. For enhancing blood glucose control among patients with HF and diabetes, future intervention programs should specifically target patients who have high WBC counts and poor medication.

Update and validation of the Canadian Behavior, Attitude and Nutrition Knowledge Survey (C-BANKS 2.0).

Understanding knowledge, attitudes and behaviors related to nutrition is crucial in developing effective intervention strategies to promote healthy eating habits. This study revised and updated the Canadian Behavior, Attitude and Nutrition Knowledge Survey (C-BANKS) to align with the current Canada's Food Guide and dietary guidance and report on its reliability and validity with a new population. Data from 167 early childhood educators were recruited to test the revised C-BANKS' reliability and validity. Reliability, as measured by internal consistency, was assessed using Cronbach's alpha, while concurrent validity was determined by correlating the C-BANKS 2.0 scores with the CHEERS (Creating Healthy Eating and Active Environments Survey) and Mindful Eating Questionnaire (MEQ). Responsiveness was assessed by comparing a baseline C-BANKS 2.0 score to a post-test score after completing an online healthy eating and physical activity educational intervention. The adapted C-BANKS 2.0 questionnaire demonstrated good internal consistency (Cronbach's alpha >0.70) and construct validity with related measures CHEERS and MEQ (p < 0.05). The C-BANKS 2.0 demonstrated strong responsiveness. Specifically, C-BANKS 2.0 scores increased after the nutrition education intervention (p < 0.001). Additionally, there were no signs of floor or ceiling effects. The adapted C-BANKS 2.0 demonstrated satisfactory internal consistency, construct validity, and responsiveness to measure of nutrition knowledge, attitudes, and behaviors in an early childhood educator population. The revised C-BANKS 2.0 provides insight into the key factors that influence dietary habits thereby informing the design and evaluation of effective nutrition community intervention programs.

Gradual parallel-process training for counseling students delivering intervention programs

Psycho-educational group counseling can be useful for counselors working with schoolchildren; however, there is a paucity of studies on the effectiveness of parallel-process training for school counseling students who deliver these programs. This qualitative-phenomenological study aims to outline a gradual training model based on parallel processes and to examine its contribution to counseling students’ professional development. Thirty-three graduate students, who participated in an Intervention Programs course and delivered 27 programs in schools, were interviewed at the conclusion of the academic year. Of them, 29 (88%) were women; 15 were Jews, 17 were Arabs (15 Muslims and two Christians), and one was a non-Arab Christian born abroad. Most interviewees (28) were married, and their mean age was 34.79 (SD = 7.57, range = 26–54). Results indicated that, despite their initial fears about their ability to conduct an intervention program, the training was effective in enhancing students’ personal and professional development and confidence. The unique in-depth training also enriched students’ skills in delivering effective intervention programs to promote pupils’ well-being. Results provide insight into improving and fine-tuning school counselor training.

Prevalence of comorbidities and its associated factors among type-2 diabetes patients: a hospital-based study in Jashore District, Bangladesh

ObjectiveThis study aimed to estimate the prevalence of comorbidity and its associated factors among Bangladeshi type-2 diabetes (T2D) patients.DesignA hospital-based cross-sectional study.SettingThis study was conducted in two specialised diabetic centres...

The Effect of ADHD Tendency on Depression and Anxiety in Elementary School Students: Mediating Effects of Friend Support

Purpose: The aim of this study was to examine the influences of elementary school students' ADHD tendency on their emotional problems such as depression and anxiety, and to verify the mediating effects of social relationships, specifically friend support, on these influences.&#x0D; Method: This study involved 456 students from two elementary schools in the capital area. The participants were surveyed regarding their ADHD tendency, friend support, depression, and anxiety levels. The data gathered were subsequently analyzed using a Structural Equation Model.&#x0D; Results: The results of the study are as follows: first, it was discovered that ADHD tendency in elementary school students directly affect friend support negatively. Second, the ADHD tendency was found to increase their levels of depression and anxiety, either directly or indirectly. Third, the ADHD tendency was shown to augment depression and anxiety via the route of friend support. Specifically, it was found that the paths of ‘ADHD tendency → friend support → depression’, ‘ADHD tendency → depression → anxiety’, ‘ADHD tendency → friend support → depression → anxiety’ were statistically significant.&#x0D; Conclusion: The findings of this study can serve as basic data for developing effective emotional intervention programs for students with ADHD tendency, by identifying the specific paths through which these students' ADHD tendency influence their emotional difficulties.

Attentional bias for rejection and sad words in Chinese left-behind children with depression.

This study aimed to examine attentional bias (AB) for sad and social rejection words in Chinese left-behind children (LBC) with depression. We investigated both stimulus specificity and components of AB in different groups using a cross-sectional design. Data were drawn from a school assessment of depression and anxiety, from which we selected LBC with depression (n = 40), LBC without depression (n = 33), a control group with depression (n = 31), and a control group without depression (n = 37). AB was measured with a dot-probe task covering two stimulus types (sad and rejection). The analysis of AB scores revealed a significant three-way interaction (LBC × depression × word type), F(1, 137) = 4.00, p = 0.047, η2 = 0.028, with depressed non-LBC exhibiting a significant depression × word type interaction, F(1, 66) = 4.67, p = 0.034, η2 = 0.066, while the depression × word type interaction was not significant in LBC, F(1, 71) = 0.18, p = 0.675, η2 = 0.002. Depressed children living with their parents showed AB towards sad words but not rejection words, while depressed LBC showed greater AB towards both rejection and sad words. The findings provide evidence that an AB towards sad information is critically involved in the depressed LBC. Compared with non-LBC depressed individuals, an AB for rejection may be involved as a risk factor in the LBC. It sheds light on the effective intervention programmes for LBC's depression and have important practical significance for reducing depression and improving the mental health of LBC.

The Effect of Paternal and Maternal Helicopter Parenting on the Career Preparation Behavior of High-School Students: Sequential Mediation Effects of Academic Achievement Attribution and Career Decision-Making Self-Efficacy

This study examined the sequential mediation effects of academic achievement attribution and career decision-making self-efficacy on the effect of paternal and maternal helicopter parenting on high-school students' career preparation behavior. A total of 285 (119 male and 166 female) Korean high-school students in the second grade participated in the study. Research variables were measured using the Career Preparation Behavior Scale (Kim, 1997), Helicopter Parenting Scale (LeMoyne &amp; Buchanan, 2011), Attribution Questionnaire (Weiner, 1979), and Career Decision-Making Self-Efficacy Scale-Short Form (Betz et al., 1996). To examine the sequential mediating effect, data analysis was performed using SPSS 29.0 and PROCESS MACRO (v4.2) Model 6. The results revealed no correlations between helicopter parenting and academic failure attribution. However, higher paternal and maternal helicopter parenting were found to indirectly reduce high-school students' career preparation behavior through lower internal academic success attribution (effort and ability) and higher external academic success attribution (task difficulty and luck), which reduced career decision-making self-efficacy. These findings can be employed to develop more effective intervention programs comprising career guidance for adolescents, which emphasizes the negative effect of helicopter parenting. This study expands the research field, as previous findings on helicopter parenting mostly focus on college students.

Ruggedness and child health outcomes: Evidence from Burundi, Cameroon, Ethiopia and Nigeria

AbstractThis paper examines the effect of terrain ruggedness on child stunting in Burundi, Cameroon, Ethiopia and Nigeria. Using a cross‐section analysis with data from the Demographic and Health Surveys (DHS) and a measure that captures variation in the terrains of the countries, we find that the more difficult it is to traverse the terrain in Burundi, Cameroon and Nigeria, the higher the likelihood of child stunting. However, this association is not consistent for Ethiopia until we account for the Oromia region, which has the capital city Addis Ababa. These results remain robust with the inclusion of socio‐economic factors related to child health (e.g. maternal health, maternal education and household income), demographic factors (e.g. gender of child), other geographical factors (e.g. rainfall patterns and malaria prevalence) and survey and region effects. The results suggest that there are complementary factors to geography that may contribute to poor child health outcomes, such as the quality of infrastructure and the ability to access healthcare services. Given that child health is a key development outcome, understanding such spatial variations associated with child health inequalities can assist in designing effective intervention programmes and allocating resources where they are most needed.

State Prevention Targeting Persons Attracted to Minors in Europe

More than a decade ago, innovative legal obligations were created in Europe to provide persons who fear that they might commit child sexual offences with access, where appropriate, to effective intervention programmes or measures designed to evaluate and prevent the risk of such offences. These supranational obligations were included in Article 7 of the Council of Europe’s Lanzarote Convention (2010) and the near-identical Article 22 of the European Union’s Directive 2011/93 (2011). These provisions have the potential to prevent damaging children’s health, to help persons attracted to minors to lead more productive and fulfilling lives, and to save society substantial resources. The European Commission noted, however, in 2020 that out of all of the state action that needs to be undertaken to implement Directive 2011/93, the least progress has to date been made in relation to prevention programmes for persons attracted to minors who fear that they might offend or have offended. This article aims to review the supranational obligations and their implementation. It finds that the stigma around pedophilia hampers progress at individual, inter-personal, and structural levels. There is room for improvement in the cooperation between the European Union and the Council of Europe. In addition, specific programmes and measures for specific target groups, such as women or people with disabilities, are identified as a blind spot.

The experience of eating for older nursing home residents with dysphagia: A qualitative descriptive study.

Understanding the experience of eating for nursing home residents with dysphagia is essential for developing effective and holistic compensatory intervention programmes for older adults with dysphagia. However, there is a lack of studies on the experience of eating for older adults with dysphagia, especially for individuals in Asian cultures. This study aimed to understand the experience of eating for older nursing home residents who have difficulty swallowing (dysphagia), which is often a problem for this population. This qualitative descriptive study recruited older nursing home residents with dysphagia from facilities in central Taiwan. Residents were recruited by purposive sampling. Data were collected through individual in-depth semistructured face-to-face interviews. Interviews were audio-recorded and transcribed interview data were analysed with content analysis. A total of 20 residents participated in the study; the mean age was 78.7 years (standard deviation = 8.54 years); male and female residents were equally represented. The main core theme describing the experience of eating for nursing home residents with dysphagia was irregular coughing, which often occurred spontaneously. Three subthemes described how residents responded: making adjustments to eating and swallowing, receiving assistance from NH staff and fear of eating. Our findings can serve as an evidence-based reference for clinical care aimed at nursing home residents with dysphagia. Support programmes that provide safe swallowing skills and emotional support for managing dysphagia are recommended. Nursing home residents with dysphagia should receive interventions focussed on self-supporting care, training in swallowing skills and emotional support.

OUT to IN: a body-oriented intervention program to promote preschoolers' self-regulation and relationship skills in the outdoors.

Time for movement and outdoor experiences has decreased in children's daily lives. Nevertheless, a growing body of research has shown that body-oriented interventions and outdoor time benefit preschoolers' social-emotional development, a foundation for mental health. OUT to IN is a body-oriented intervention program implemented outdoors, designed to promote preschoolers' social-emotional competence. This study aimed to evaluate the effects of OUT to IN on preschoolers' self-regulation and relationship skills. A cluster randomized trial with multi-method and multi-informant assessment was implemented including 233 children between 3 and 6 years (122 boys, Mage = 5.07 years), from 4 preschools (8 groups with OUT to IN intervention, 4 groups without intervention - control group). The 153 children allocated to the OUT to IN group participated in biweekly sessions for 10 weeks. OUT to IN sessions followed a body-oriented approach comprising exercise play, relaxation, and symbolization activities, implemented outdoors by a psychomotor therapist and the preschool teacher. Sessions enabled children to feel, observe and control their bodily states and understand the relationship between their bodies and emotions. Teachers participated in a brief course and on 20 biweekly relaxation sessions. Children's self-regulation was measured through specific tasks and a parent questionnaire. Relationship skills (i.e., empathy, communication, cooperation and sociability) were measured through parents' and preschool teachers' questionnaires. Mann-Whitney test was used to study differences at baseline between the OUT to IN group and the control group, and to study differences in the 10-week changes between both groups. Wilcoxon Test was used for intragroup comparisons. After the 10-week intervention period, children who participated in OUT to IN showed significant improvements on self-regulation and relationship skills (empathy, cooperation and sociability), in comparison to the control group who did not show any significant improvements. Large size effects (η2 > 0.14) were found for most of the variables related to self-regulation and small (η2 > 0.01), medium (η2 > 0.06) and large size effects (η2 > 0.14) were found for the variables related to relationship skills. OUT to IN showed to be an effective body-oriented intervention program in improving children's self-regulation and relationship skills, which are recognized foundations for mental health and well-being.

Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses.

Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature. The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence. A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience. Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial. This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.

Addressing family mutism: Expert perspectives and intervention strategies in the context of excessive social media use in Saudi Arabian families

This study explores the perspectives of social science experts on the emergence of family mutism resulting from the misuse of social networking platforms. It also seeks to identify the most effective social intervention program to restore Saudi Arabian family bonds strained by excessive social media use. This research is theoretically grounded in the cognitive framework of clinical sociology. The researchers adopted a descriptive methodology and conducted directed interviews with 20 experts from different disciplines at Hail University in Saudi Arabia, during the months of October and November 2022. The study reveals that the experts reached a unanimous consensus on the goals of the therapeutic intervention program, emphasizing the enhancement of family members' awareness and the provision of guidance on the prudent use of social media. From a theoretical perspective, all experts agreed that ecological theory served as the most appropriate framework to inform professional practice and guide the social intervention program. In addition, the study found that individual and group interviews with family members, along with individual and group sessions, were the most effective social intervention strategies. Professionals reflected on the complex social and psychological issues associated with family mutism, particularly in children and adolescents who are enmeshed in technological addiction and excessive reliance on social networking platforms. According to these specialists, family structure plays a pivotal role in mitigating family mutism, as they assert their competence in identifying the problem. This study provides invaluable insights into the optimal goals, theoretical paradigms, methodologies, and tools to address family mutism resulting from the inappropriate use of social media.

The Unique Role of Peer Support: Exploring the Effects of Various Sources of Social Support on the Mental Health of Unaccompanied Children in China under Residential Education.

This study investigates the impact of various sources of social support on the mental health of unaccompanied children under residential education in China. Unaccompanied children refer to those whose parents are still alive but unable to raise them due to various reasons. The study utilized self-reported questionnaires administered at two time waves, with the first wave (T1) evaluating family support, teacher support, and peer support, and the second wave (T2) evaluating depression, subjective well-being, and resilience. A total of 202 participants completed both surveys. To examine the predictive effect of different sources of social support on the mental health of these children, the study used the structural equation model with depression and subjective well-being as indicators. The results show that neither family support nor teacher support (T1) had a significant effect on the mental health (T2) of the children. However, peer support (T1) had a significant positive predictive effect on mental health (T2), indicating the unique role of peer support in promoting the mental health of unaccompanied children. The study also explored the mediating role of resilience between social support and well-being, revealing that though the direct effect of teacher support (T1) on mental health (T2) was not significant, the indirect mediating effect of resilience on the relationship between teacher support and mental health was significant. Both the direct and indirect effect of family support (T1) on mental health (T2) were not significant. These findings highlight the importance of creating a positive peer environment for unaccompanied children to promote their mental health. This study has important practical implications for the development of effective intervention programs aimed at improving the mental health of this population.

METHOD OF DISCRETE SINGULARITIES FOR ACCOUNTING FOR CONVECTION WHEN MODELING DYNAMICS OF INFECTIOUS DISEASE UNDER DIFFUSION PERTURBATIONS AND CONCENTRATED INFLUENCES

A wide range of various mathematical models have been developed to predict the dynamics of an infectious disease. As a rule, such models do not take into account spatial effects, which are associated with both the uneven distribution of active factors and their convective transfer by the intercellular fluid. The paper proposes a variant of taking into account convection when modeling the process of an infectious disease under conditions of diffusion perturbations and concentrated influences. Based on the reduction of original singularly perturbed model problem with delay to a sequence of problems without delay, an effective step-by-step procedure for numerically asymptotically approximating the solution as a perturbation of the solution of the corresponding degenerate problems is synthesized. To find the velocity field, it is proposed to model the movement of fluid in the intercellular medium as a potential flow in the source-drain system. It is emphasized that this approach can be used for a wide range of configurations of model areas with sufficient variability of boundary conditions. The results of computer modeling are presented, which illustrate the influence of diffusion scattering and convection on the development of a viral disease under the conditions of injections of immunological drugs. It is shown that as a result of diffusion scattering and convective transfer of viral elements, their concentration in the epicenter of infection decreases over time, which leads to a corresponding decrease in the "severity" of the disease. It is also shown that with an uneven field of movement speed of the intercellular fluid, there will be zones with a less intense influx of both own and donor antibodies. As a result, the amount of antibodies available in these zones may be insufficient to neutralize antigens, which may lead to the emergence of new epicenters of infection here. The importance of taking such effects into account, in particular, when forming effective treatment programs, is indicated.

Evaluating the Effectiveness of Take it Personal!+ in People With Mild Intellectual Disability or Borderline Intellectual Functioning and Substance Use Disorder: A Multiple Baseline Single-Case Experimental Study

Individuals with mild intellectual disabilities or borderline intellectual functioning are at increased risk to develop a substance use disorder—however, effective treatment programs adapted to this target group are scarce. This study evaluated the effectiveness of Take it Personal!+ in individuals with mild intellectual disabilities or borderline intellectual functioning and substance use disorder. Take it Personal!+ is a personalized treatment based on motivational interviewing and cognitive-behavioral therapy supported by an mHealth application. Data were collected in a nonconcurrent multiple baseline single-case experimental design across individuals with four phases (i.e., baseline, treatment, posttreatment, and follow-up). Twelve participants were randomly allocated to baseline lengths varying between 7 and 11 days. Substance use quantity was assessed during baseline, treatment, and posttreatment with a daily survey using a mobile application. Visual analysis was supported with statistical analysis of the daily surveys by calculating three effect size measures in 10 participants (two participants were excluded from this analysis due to a compliance rate below 50%). Secondary, substance use severity was assessed with standardized questionnaires at baseline, posttreatment, and follow-up and analyzed by calculating the Reliable Change Index. Based on visual analysis of the daily surveys, 10 out of 12 participants showed a decrease in mean substance use quantity from baseline to treatment and, if posttreatment data were available, to posttreatment. Statistical analysis showed an effect of Take it Personal!+ in terms of a decrease in daily substance use in 8 of 10 participants from baseline to treatment and if posttreatment data were available, also to posttreatment. In addition, data of the standardized questionnaires showed a decrease in substance use severity in 8 of 12 participants. These results support the effectiveness of Take it Personal!+ in decreasing substance use in individuals with mild intellectual disabilities or borderline intellectual functioning.